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Advances in Microbiology

Advances in Microbiology

 Rapid identification of microorganisms in the clinical microbiology laboratory can be of great value for selection of optimal patient-management strategies for infections caused by bacteria, viruses, fungi, mycobacteria, and parasites. The switch to tailored therapy minimizes risks of antibiotics, namely, disruption of normal flora, toxic side effects, and selective pressure. There is a critical need for new technologies in clinical microbiology, particularly for bloodstream infections, in which associated mortality is among the highest of all infections. The field of microbiology is moving exceptionally fast, in part because it can take full advantage of the new developments in microscopy, computational biology, synthetic biology, labon-chip approaches, and single-cell technologies. Advanced microbiology technologies are rapidly changing the ability to diagnose infections, improve patient care, and enhance clinical workflow. These tools are increasing the breadth, depth, and speed of diagnostic data generated per patient, and testing is being moved closer to the patient through rapid diagnostic technologies, including point-of-care (PoC) technologies. While select stakeholders have an appreciation of the value/ importance of improvements in the microbial diagnostic field, there remains a disconnect between clinicians and some payers and hospital administrators in terms of understanding the potential clinical utility of these novel technologies. Therefore, a key challenge for the clinical microbiology community is to clearly articulate the value proposition of these technologies to encourage payers to cover and hospitals to adopt advanced microbiology tests. Specific guidance on how to define and demonstrate clinical utility would be valuable. Addressing this challenge will require alignment on this topic, not just by microbiologists but also by primary care and emergency room physicians, infectious disease specialists, pharmacists, hospital administrators, and government entities with an interest in public health. Both the pharmaceutical and diagnostic manufacturing industries will also be required to be involved in orchestrating the generation of clinical-utility evidence. Given that hospital administrators often prefer to undertake a trial period with new technologies to gain first-hand experience, diagnostic technology manufacturers may need to pursue collaborations for this to be actively achieved. Furthermore, they can work to guide not only microbiologists but also facilitate early partnership with those in clinical and financial roles about the design of studies, which could help illustrate the clinical utility of these deployed tools in a fair and balanced way. They can also play a role in helping community hospitals understand where to find clinical-utility information and how to share clinical-utility information so that advanced care approaches are not limited to academic medical centers alone.Additionally, pharmaceutical leaders in the microbiology space may be required to actively participate in data gathering and publication, supporting the concept that next-generation antimicrobials may be more effective, particularly if paired with the most advanced diagnostic technologies. This will likely require active collaboration between pharmaceutical and diagnostic companies to ensure the clinical-utility benefit of appropriate prescribing of next-generation treatments is influenced by novel technologies entering the space.